A DECISION on whether or not Gwent gets its long-awaited Specialist and Critical Care Centre is now unlikely until late in the year - but the Welsh Government must act quickly once proposals for the reorganisation of key hospital services across South Wales are agreed.

AFTER 10 years of planning, a further delay of a couple of months before a decision is made on a business case for the proposed Specialist and Critical Care Centre for Gwent does not seem too onerous.

For a project that at one stage during that decade had its planning process frozen for a year due to the economic downturn, this latest delay might appear insignificant.

But with the NHS in Wales, in common with much of the rest of the UK, struggling to cope with increasing demand and major budget cuts, it is another unwelcome obstacle in what has been a tortuous path.

Aneurin Bevan Health Board submitted its outline business case for the £270 million centre - which will treat Gwent's sickest patients - last December, with the hope that it might get a decision from the Welsh Government by the end of March or April.

Health minister Professor Mark Drakeford then ruled that a decision would be postponed until after the reorganisation of emergency, neonatal, paediatric and maternity services in South Wales hospitals was settled.

The latter has been subject to a year-long planning and consultation process and after a second public consultation finished in July, it was envisaged that final proposals would be published this month, with health boards in the region approving the way forward for these services in October.

An unprecedented response - more than 53,000 responses are currently being evaluated - means that decision process has been deferred until nearer the end of the year.

The SCCC project is important in all this because it is a vital part of all four options for the reorganisation of the aforementioned services across South Wales. A decision on the outline business case was postponed because Professor Drakeford did wish it to pre-empt the conclusions of, and recommendations for, that reorganisation.

Now the British Medical Association Cymru, which represents doctors in Wales, has weighed in with strong criticism of a hospital services reorganisation that has as one of its cornerstones the assumption that the SCCC will be built.

Four options were put out for consultation during May-July, with the SCCC a key part of all of them, along with the University Hospital of Wales in Cardiff, and Morriston Hospital in Swansea.

BMA Cymru believes it is "dangerous" to include the SCCC as such a vital component until there is greater certainty about its getting the go-ahead.

And if the hospital does finally get the nod, BMA Cymru is also concerned about what it sees as a lack of detail over what happens to sustain existing services between now and the hospital opening.

The estimate is that it would open sometime during 2018/19, though the latest delay and any unforeseen subsequent delays could push it back still further.

But the health board has already warned of certain services, such as neonatal and inpatient paediatrics, being fragile and difficult to sustain on two sites - the Royal Gwent and Nevill Hall - as they are at present, with staffing difficulties the main problem.

THE health board is looking at options to reorganise these 'fragile' services if the current model becomes unsustainable, though details have not been finalised.

Against this backdrop of difficulties in maintaining current services, and the criticism of BMA Cymru, a further delay over a decision on the SCCC, however short, is unwelcome.

If the SCCC has been accepted as such a fundamental part of future acute hospital services provision in South Wales, as the options suggest, then why delay a decision on its going ahead?

Rather than pre-empt the outcome of the reorganisation process, surely a thumbs up for the SCCC would strengthen the process itself?

It has been accepted universally for years that retaining the current Royal Gwent-Nevill Hall Hospital model for acute services is a non-starter.

It has its critics, but as things stand, the SCCC is the only option on the table for acute hospital services modernisation in Gwent. Millions of pounds have been invested in its planning and no alternatives have been developed.

It is of course right that responses to such an important issue as regional hospital services reorganisation be carefully considered ahead of any decision - but for them to make sense, the SCCC has to go ahead.

Hopefully, the Welsh Government will follow the services reorganisation decision rapidly - however late in the year it might come - with another about the building of the SCCC.